Objective: Neurocognitive impairment is commonly reported at onset of psychotic disorders. However, the long-term neurocognitive course remains largely uninvestigated in first episode psychosis (FEP) and the relationship to clinically significant subgroups even more so. We report 10 year longitudinal neurocognitive development in a sample of FEP patients, and explore whether the trajectories of cognitive course are related to presence of relapse to psychosis, especially within the first year, with a focus on the course of verbal memory. Method: Forty-three FEP (...) subjects (51% male, 28±9 years) were followed-up neurocognitively over five assessments spanning 10 years. The test battery was divided into four neurocognitive indices; Executive Function, Verbal Learning, Motor Speed, and Verbal Fluency. The sample was grouped into those relapsing or not within the first, second and fifth year. Results: The four neurocognitive indices showed overall stability over the ten year period. Significant relapse by index interactions were found for all indices except Executive Function. Follow-up analyses identified a larger significant decrease over time for the encoding measure within Verbal Memory for patients with psychotic relapse in the first year (F (4,38)=5.8, p=0.001, η2=0.40) Conclusions: Main findings are long-term stability in neurocognitive functioning in first episode psychosis patients, with the exception of verbal memory in patients with psychotic relapse or non-remission early in the course of illness. We conclude that worsening of specific parts of cognitive function may be expected for patients with on-going psychosis, but that most patients should expect no change in cognitive performance during the first 10 years after being diagnosed. (shrink)

The aim of this study was to explore and reflect upon mental health nursing and first-episode psychosis. Seven multidisciplinary focus group interviews were conducted, and data analysis was influenced by a grounded theory approach. The core category was found to be a process named ‘working behind the scenes’. It is presented along with three subcategories: ‘keeping the patient in mind’, ‘invisible care’ and ‘invisible network contact’. Findings are illuminated with the ethical principles of respect for autonomy and paternalism. Nursing (...) care is dynamic, and clinical work moves along continuums between autonomy and paternalism and between ethical reflective and non-reflective practice. ‘Working behind the scenes’ is considered to be in a paternalistic area, containing an ethical reflection. Treating and caring for individuals experiencing first-episode psychosis demands an ethical awareness and great vigilance by nurses. The study is a contribution to reflection upon everyday nursing practice, and the conclusion concerns the importance of making invisible work visible. (shrink)

(1999). The Statesman and the Ophthalmologist: Gladstone and Magnus on the Evolution of Human Colour Vision, One Small Episode of the Nineteenth-century Darwinian Debate. Annals of Science: Vol. 56, No. 1, pp. 25-45.

Introduction: In the Ebbinghaus illusion, a shape appears larger than its actual size when surrounded by small shapes and smaller than its actual size when surrounded by large shapes. Resistance to this illusion has been previously reported in schizophrenia, and linked to disorganized symptoms and poorer prognosis in cross-sectional studies. It is unclear, however, when in the course of illness this resistance first emerges or how it varies longitudinally with illness phase. Method: First-episode psychosis patients, multiple-episode schizophrenia patients (...) and healthy controls completed a psychophysical task at two different time points, corresponding to hospital admission and discharge for patients. The task required judging the relative size of two circles centered on either side of the screen. Targets were presented without context (baseline), or were surrounded by shapes that made the size judgment harder or easier (misleading and helpful contexts, respectively). Context sensitivity was operationalized as improvement relative to baseline in the helpful condition minus the amount of decrement (relative to baseline) in the misleading condition. Results: At admission, context sensitivity was lower in the multiple-episode group than in the other groups, and was marginally less in the first episode than in the control group. In addition, schizophrenia patients were significantly more and less accurate than the other groups in the misleading and helpful conditions, respectively. At discharge, all groups exhibited similar context sensitivity. Poorer context sensitivity was related to higher levels of disorganized symptoms, and lower level of depression, excitement, and positive symptoms. Discussion: Resistance to the Ebbinghaus illusion, as a characteristic of the acute phase of schizophrenia, emerges after the first episode of psychosis. This suggests that visual context processing is a state-marker in schizophrenia and a biomarker of relapse and recovery. (shrink)

After three proceedings in which neuroscience was a relevant factor for the final verdict in Italian courts, for the first time a recent case puts in question the legal relevance of neuroscientific evidence. This decision deserves international attention in its underlining that the uncertainty still affecting neuroscientific knowledge can have a significant impact on the law. It urges the consideration of such uncertainty and the development of a shared management of it.

Valerius Flacgus has few readers and still fewer admirers, even among classical specialists. Most of us, if we want to refresh our memories of Hylas, will turn to Theocritus' thirteenth Idyll or perhaps to Propertius' statuesque version . Apollonius Rhodius is read mainly in his third book, so that his Hylas story at the end of the first is ignored, and Valerius Flaccus is hardly read at all. In the year 1894 W. C. Summers in A Study of the Argonautica (...) of Valerius Flaccus called for a fair reappraisal of the much-neglected poet. The works of the few scholars who have since attempted a literary assessment lie, for the most part, obscurely stored in the stacks of those Teutonic universities that awarded them a Ph.D. (shrink)

The article discusses the first attempt to establish an independent bhikkhu-sa?gha in England in 1956 and the reasons that this initial attempt failed. The account draws on testimony from George Blake, one of the monks ordained under this initiative. After a short contextualization of the situation in which Blake met with Buddhism in London, there follows a further discussion of two issues on which his evidence sheds fresh light: the falling out of the British monk Kapilava??ho with Luang Por Sodh (...) (Phra Mongkolthepmuni), the abbot of Wat Paknam in Bangkok; and the move away from the teaching of the so?asak?ya meditation at the English Sangha Trust in London. (shrink)

Although scholars have expended increasing efforts over the last twenty years or so in either detecting or establishing large structural and thematic units within Ovid's perpetuum carmen, little attention, as far as I am aware, has been directed towards the evident care taken by Ovid in his arrangement of material within individual episodes, and the resultant over-all structure of those episodes. The aim of the present paper is to focus attention upon a single episode to which Ovid seems to (...) have paid particular attention in these respects. I refer to the long story of Phaethon, which occupies the last part of book 1, and most of the first half of book 2, of the Metamorphoses, and intend to explore two different lines of approach in examining the structure of this episode. (shrink)